Mobile health to improve tuberculosis care and control: a call worth making [Review article]

Abstract

The use of mobile phones has substantially increased throughout the world over the last decade. This has opened up opportunities for the integration of mobile phones as health intervention tools in many aspects of health care, including prevention, diagnosis, data collection, treatment and adherence monitoring and surveillance. Several applications have been explored in human immunodeficiency virus care. The field of tuberculosis (TB) has not exploited the potential of mobile health (m-health) to the same extent, although the opportunities have been recognized. A number of proof-of-concept and pilot studies have been published on m-health in TB care, and an even larger number of studies are available in the grey literature. This article summarizes publications and recent developments at the intersection of TB care and m-health. We show that more rigorous studies evaluating different applications and implementation strategies are needed to establish an evidence base that serves to inform policy and decision making. We outline further areas of research that should be addressed and potential challenges that lie ahead if m-health applications are to enhance the accessibility and quality of TB care.

ODK Scan: Digitizing Data Collection and Impacting Data Management Processes in Pakistan’s Tuberculosis Control Program

“…This setting informed the selection of ODK Scan paper-to-digital system. In other mHealth interventions where Android-based smartphones are used primarily for data collection, the ability of smartphones to transfer data in real time from remote areas to centrally located offices is achieved by exploiting the internet connectivity [15,32]. Similarly, in this field test, internet connectivity benefited field workers in transferring the data and labor involved in sharing the data in the form of hard copies was avoided.…”

Text Messages Sent to Household Tuberculosis Contacts in Kampala, Uganda: Process Evaluation (Preprint)

“…The potential for mobile phones to improve access to evaluation and treatment for TB by enhancing communication between at-risk individuals and health care workers has generated great enthusiasm for mobile health technologies, especially SMS [22,23]. However, data about how these interventions actually work -or do not work -in routine practice are limited [24].…”

“…Median age among adult participants was 27 years of age (interquartile range (IQR) [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] Step 2: SMS Received…”

Use of the WelTel mobile health intervention at a tuberculosis clinic in British Columbia: a pilot study

“…These include the SIMpill, a medication container that delivers a text to a central server when opened, and the Adhere.IO system, an incentive-based system in which patients text a code that is revealed when they urinate on a filter paper and TB drug metabolites are detected. 10 Unlike these other interventions, WelTel does not require distributing additional devices to patients to report adherence, and it involves regular and when required, personalized communication with the clinic on a broad range of issues. Potential advantages of the WelTel service include its simplicity, its use of technology already in the hands of most patients (a standard mobile phone), and that the provision of a regular 'check-in' may be perceived as more supportive by patients than interventions specifically designed to 'monitor' treatment adherence.…”